To investigate the clinical effect and safety of delicate pulsed light combined with salicylic acid in the treatment of rosacea. Methods A total of 84 patients with rosacea admitted to our hospital from August 2022 to May 2023 were randomly divided into control group and observation group, with 42 patients in each group. The control group was treated with salicylic acid, and the observation group was treated with delicate pulsed light combined with salicylic acid. The clinical effect, incidence of adverse reactions, facial skin lesion score and quality of life were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.62%, which was higher than 76.19% in the control group (P <0.05). The incidence of adverse reactions in the observation group was 2.38%, which was lower than 16.67% in the control group (P<0.05). The scores of telangiectasia, papules, pustules and pruritus in the observation group were lower than those in the control group (P<0.05). The quality of life score of the two groups after treatment was lower than that before treatment, and the observation group was lower than that of the control group (P<0.05). Conclusion For patients with rosacea, the efficacy and safety of delicate pulsed light combined with salicylic acid are high, which can effectively improve the skin condition of patients and improve their quality of life.